Stefan James Wilkes, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

9573 Issued in SC

Practice address

150 Country Club Rd
Spartanburg, SC 29302-3364

Phone

(864) 583-3717

Fax

(864) 573-6067

NPI assigned

Apr 1, 2018

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Carolina Smiles, LLC

  • General Practice Dentistry
  • Spartanburg, SC
  • NPI 1952528127
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1522540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589414400000",
    "number": "1629574595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 PROVIDENCE LN",
            "city": "MC CORMICK",
            "state": "SC",
            "postal_code": "298354230",
            "telephone_number": "864-293-9454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 COUNTRY CLUB RD",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293023364",
            "telephone_number": "864-583-3717",
            "fax_number": "864-573-6067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKES",
        "first_name": "STEFAN",
        "middle_name": "JAMES",
        "name_prefix": "Mr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-04-01",
        "last_updated": "2020-05-14",
        "certification_date": "2020-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "9573",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Poole Wilcox, O.D.
• Margaret Ellen Wilcox, ADC-P
• Audrey Anne Wildeman, PA-C
• Douglas Larry Wiley, D.O.
• Cortella Wilkes, DNP
• Wilkins Opticians of Spartanburg,Inc
• Ava L Wilkins
• Diane Leigh Wilkins, LISW-CP
• Jeffrey Scott Wilkins, ABOM
• Laura B Willard, AGACNP-BC

• General Practice Dentistry in Spartanburg, SC
• Providers in Spartanburg, SC by specialty
• General Practice Dentistry in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.